Abstract T P162: Cardio-Ankle Vascular Index (CAVI) predicts Cardioembolic Stroke in Patients with Atrial Fibrillation

Abstract

Arteriosclerosis has shown to be a definite risk factor of atrial fibrillation, which is an important cause of cardioembolic stroke. The cardio-ankle vascular index (CAVI) has been reported as a novel parameter for arterial stiffness, and high CAVI implies progression of carotid and coronary arteriosclerosis. However, it remains to be determined whether CAVI is associated with cardioembolic stroke. We performed CAVI and transesophageal echocardiography in 219 patients with paroxysmal or chronic atrial fibrillation (165 males, 64 ± 12 years), including 53 patients with the history of cardioembolic stroke. CAVI was higher in patients with hypertension, diabetes mellitus, chronic atrial fibrillation and the history of heart failure compared with those without them. CAVI showed a good correlation with age, systolic blood pressure, pulse pressure, fasting blood glucose, high-sensitivity CRP, fibrinogen and von Willebrand factor. CAVI was also associated with left atrial dimension, left atrial volume index, left atrial emptying fraction, left ventricular diastolic function and left atrial appendage emptying flow velocity. CAVI was significantly increased with advancing grade of spontaneous echo contrast and increasing CHADS 2 score and CHA 2 DS 2 VASc score. Furthermore, CAVI was significantly different between patients with score 0 and score 1 in CHADS 2 and CHA 2 DS 2 VASc. CAVI was significantly higher in patients with left atrial appendage thrombus than in those without (10.3 ± 2.4 vs. 8.5 ± 1.6, P<0.0001). CAVI was also significantly higher in patients with cardioembolic stroke than in those without (10.6 ± 2.2 vs. 8.3 ± 1.2, P<0.0001). Logistic regression analysis revealed that CAVI was an important risk factor for cardioembolic stroke after adjustment of age and heart rhythm (odds ratio 2.16, 95% confidence interval 1.55-3.01). The patients with CAVI ≥ 9 had 12 times higher risk for cardioembolic stroke compared with those with CAVI < 9 after adjustment of age and heart rhythm. In conclusion, CAVI is a novel parameter to predict cardioembolic stroke in patients with atrial fibrillation.